Schizotypic Personality Disorder – Causes, Symptoms & Treatment

Schizotypal Personality Disorder

Schizotypal personality disorder is a serious mental disorder. Those affected suffer from significant changes in their feelings and relationships.

What is schizotypal personality disorder?

Schizotypal personality disorder is also known as schizotypal disorder . It should not be confused with schizoid personality disorder. This mental illness leads to severe behavioral deficits that affect the psychosocial and interpersonal area.

The medical classification of the schizotypal personality disorder is not clear. The ICD-10 key does not classify the disease as a personality disorder , but rather as a delusional and schizophrenic disorder. In contrast, the US DSM-IV classification does classify the mental disorder as a personality disorder. This makes an exact classification of the schizotypal personality disorder difficult. It was only recently that it was differentiated from schizoid personality disorder.


The exact causes of the schizotypal personality disorder have not yet been clearly determined. Experts suspect a multicausal origin of the mental disorder. Possible triggers include genetic factors. The schizoztypical disorder often appears within families in which schizophrenia already occurred. Therefore, physicians assume that there is a common genetic predisposition for both mental illnesses .

Traumatic experiences in early childhood can also play a role. For example, people with schizotypal disorder were often physically abused or sexually abused in their childhood. A difficult birth is also considered a traumatic experience. Another possible cause is neglect of the affected person in early childhood. The patients did not have a close relationship with their parents during this period. A conceivable reason for this could be a mental illness on the part of the mother, as a result of which she does not fulfill her role to a sufficient extent. Hospitalism is assumed to be a further cause .

Symptoms, Ailments & Signs

Within the framework of the schizotypal personality disorder, the affected persons experience profound interpersonal and social deficits. For example, patients are unable to form close relationships because they make them uncomfortable. In addition, they suffer from distortions in thinking and perception. Social contacts are very rarely made by those affected. Due to their deep distrust of other people, their relationships don’t last long.

Even if they’ve been with someone for a long time, they can’t shake off their distrust. Often the opposite is the case and the feelings of suspicion increase. It is not uncommon for those affected to be irritable and aggressive . They also come across as lacking in emotion, indifferent and unapproachable .

In addition, people suffering from schizotypal personality disorder develop behavior that is classified as unconventional. This includes, among other things, an unkempt or bizarre appearance. In addition, the patients use a peculiar language. This can be intricate, contrived and awkward. Some sufferers manage to create extraordinary works of art, which is due to their pronounced sensitivity.

However, artistic talent is very rarely present in people with severe schizophrenia. Instead, their thinking tends to be more abstract or technically functional. Other possible symptoms of schizotypal personality disorder are the development of paranoid ideas, ideas about relationships or autistic sinking. In addition, those affected often brood obsessively, with their thinking often being aggressively or sexually motivated. In severe cases, hallucinations are also possible. Around two-thirds of all patients have other mental disorders. It can be depression , anxiety disorders , addictions or eating disorders .

Diagnosis & disease progression

Identifying a schizotypal personality disorder is not always easy. Hardly any patients visit a doctor of their own accord. The therapist bases his diagnosis on the patient’s medical history and on the typical symptoms of the disorder such as obsessive brooding, paranoid ideas, eccentric behavior patterns, idiosyncratic appearance, social withdrawal or hallucinations.

As a rule, the schizotypal personality disorder takes a chronic course. The intensity varies from person to person. In some cases there can be clear schizophrenia. The course of the mental illness usually corresponds to a conventional personality disorder.


Schizotypal personalities are often withdrawn and have little contact with other people. Many of them have poor social skills. This sometimes results in complications for friendships, acquaintances and family life. The professional career can also suffer from the social deficits – both in dealing with customers as well as with colleagues and superiors.

Aggressive behavior is possible but does not affect all people with schizotypal personality disorder. If the sufferer is suffering from paranoid thoughts, these can also lead to complications. The high level of distrust in some cases represents an obstacle to treatment as the schizotypal personality may not seek help.

Sometimes not only psychological help is refused, but also medical, for example, in the event of an injury or illness. As a result, it is possible for such a physical illness to worsen unnecessarily. The schizotypal personality disorder can accompany another personality disorder or be accompanied by another mental illness. Common comorbidities of personality disorders include anxiety disorders and depression.

Some sufferers develop an eating disorder or substance dependence. This arises in part in an attempt to find a “medicine” against the schizotypal complaints. For example, some sufferers drink alcohol to be more relaxed and less inhibited in social situations. Such attempts can easily lead to the vicious cycle of addiction.

When should you go to the doctor?

Behavioral problems or peculiarities of social interaction should always be examined by a doctor. In the case of emotional detachment, the inability to form social bonds or a strong distrust of other people, it is advisable to clarify the symptoms. A lack of awareness of the illness is characteristic of a schizotypal personality disorder. Those affected experience themselves as normal and see the problems in the people around them. It is therefore a challenge to persuade the affected person to see a doctor. A close and stable relationship is necessary, but this is typically rejected due to the disease.

In the event of emotional distress or discomfort in contact with other people, consultation with a doctor should be sought. If there is an aggressive appearance, emotional injuries or the repeated disregard of social rules, a doctor’s visit is advisable. In particularly serious cases, a medical officer should be called.

Self-harmful or injurious actions are worrying. You should be presented to a doctor. In the case of hallucinations, delusions, strong fears or a depressive appearance, the person concerned needs help. A doctor is needed as soon as the symptoms become a burden in everyday life or new symptoms appear. Eating behavior disorders or addiction tendencies are also characteristic of the personality disorder and should be examined.

Treatment & Therapy

The treatment of the schizotypal personality disorder is just as difficult as the diagnosis. Quite a few patients resist therapy in the initial phase. Cooperation with them can only be achieved through the art of persuasion or coercion by partners or relatives. Other health problems such as addictions or depression also play a role.

As with all other personality disorders, healing the illness is not the focus of schizotypal personality disorder. Rather, the social competence and the social environment of the patient should be improved. Psychotherapy and sociotherapy are used for this . At the beginning of treatment, it is considered important to establish a trusting relationship between patient and therapist. However, this is usually a major challenge for everyone involved. If the establishment of a sustainable relationship is not successful, this ends with the termination of the treatment.

If the patient suffers from other mental disorders, he is given appropriate medication, such as antidepressants in the case of depression. If, on the other hand, there is an accompanying anxiety disorder, neuroleptics are often administered to him. Other options include lithium and carbamazepine, which ensure stability. Sedatives such as benzodiazepines are used to treat panic attacks.


Since the causes of schizotypal personality disorder are not exactly known, no suitable preventive measures are available.


Psychotherapeutic aftercare is necessary for a schizotypal personality disorder. Duration and intensity (i.e. the frequency of therapy sessions) depend on the severity of the disease. Schizotypal personality disorders are associated with behavioral problems. Behavioral aftercare is therefore recommended in parallel with psychotherapy.

After a stay in the psychiatric ward, the person concerned is given follow-up care when they return to everyday life. The goal is a largely symptom-free life after the treatment has been completed. Mutual trust between the doctor and the patient is a basic prerequisite for successful aftercare. During follow-up treatment, the patient learns how to deal consciously with his or her illness.

At the same time, his self-esteem should be strengthened, since those affected often experience social stigmatization. This can happen at work, in the circle of acquaintances or within the family. Relatives who are overwhelmed also have the opportunity to contact the psychotherapist with personal questions. In the case of drug treatment, the therapist monitors the long-term healing progress.

A resulting dependence on medication should be prevented. If there is no improvement or worsening, the dose is increased, more appropriate medicine is given, or the entire therapeutic approach is changed. As part of the aftercare, the specialist arranges for a hospital referral if the patient’s condition deteriorates significantly and/or he requests it himself.

You can do that yourself

The schizotypal personality disorder can progress to schizophrenia. Schizophrenia is essentially characterized by stronger and clearer symptoms than the schizotypal personality disorder. However, the nature of the symptoms is similar. Therefore, it makes sense for those affected to monitor themselves closely and inform their doctor or therapist if their symptoms worsen .

The external living conditions also deserve attention. Not all living conditions can be controlled – a job loss or a divorce is usually not wanted. However, those affected should keep in mind that the probability of a relapse or deterioration is particularly high in such phases of life. Good self-care is therefore particularly important in these times.

A stable environment helps to stabilize the psyche . In everyday life, people with a schizotypal personality disorder can take care to maintain regular social contacts that they find pleasant. However, one of the characteristics of schizotypal personality disorder is that sufferers have difficulty forming and maintaining deep relationships. Therefore , psychologists consider targeted training of social skills to be useful. If self-help is not enough, behavioral social training is an option.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.